1.Inhalation toxicity of suspended particulate pesticide-supracide FD.
Mitsuru ANDO ; Kenji TAMURA ; Ken KANAYA ; Shinji ASANUMA ; Shosui MATSUSHIMA ; Ichisuke KAWAHARA
Journal of the Japanese Association of Rural Medicine 1988;37(4):873-878
To study the potential health effects of suspended particulate pesticide-Supracide FD, the animals were exposed to the pesticide particle in the inhalation exposure chamber. The suspended particulate pesticide was approximately 2.16μm mass median diameter.
The animals exposed to suspended particulate pesticide had a considerable amount of particles throughout the alveolar region.The particles deposited mainly within alveolar macropharge and alveolar epithelium. The epithelial lesion of the pulmonary tissue and the vacuolar degeneration of hepatic cell of the animals occured after inhalation of pesticide particle.
The exposure to Supracide FD induced production of more thiobarbituric acid reacting substances (TBARS) in comparison to the controls. The change of serum GOT and LDH activities after exposure to pesticide particle was also remarkable. The exposure to the pesticide particle caused no significant effect on the serum cholinesterase activity.
2.Secundum type atrial septal defect with cleft mitral valve.
Shigeaki AOYAGI ; Ken-ichi KOSUGA ; Ko TANAKA ; Yoshikatu NISHI ; Hiroto INUTUKA ; Fumihiko ANDO ; Kiroku OISHI
Japanese Journal of Cardiovascular Surgery 1989;19(1):28-31
A rare case of secundum type atrial septal defect associated with cleft of the anterior mitral leaflet in 63-year-old man is reported. The electrocardiogram showed right bandle branch block and indeterminate QRS axis. Preoperative cardiac catheterization revealed left to right shunt at the atrial level and moderate mitral regurgitation due to a cleft in the anterior mitral leaflet. Marked tricuspid regurgitation due to a dilated annulus concomitantly existed. The valve deficiencies were repaired and the atrial septal defect was closed at operation. Forty cases of secundum type atrial septal defect associated with cleft mitral valve were discussed about their electrocardiograms and operative indications.
3.A Case Report of Candida endocarditis Associated with Giant Fungus Ball on the Tricuspid Valve.
Shigeaki AOYAGI ; Masashi KOGA ; Shigemitsu SUZUKI ; Fumihiko ANDO ; Ko TANAKA ; Atsushige ORYOJI ; Ken-ichi KOSUGA ; Kiroku OISHI
Japanese Journal of Cardiovascular Surgery 1991;20(7):1299-1302
A case of 41-year-old man with large candidal vegetation on the tricuspid valve was reported. He was presented with high fever and newly developed heart murmur. Four months before admission, he had suffered from head trauma which required intravenous hyperalimentation and injection of multiple antibiotics through catheter indwelling the superior vena cava. On admission, echocardiogram showed large vegetation on the tricuspid valve, although blood cultures were sterile. At operation, tricuspid valve was replaced with St. Jude Medical prosthesis because large vegetation developed from the anterior tricuspid leaflet was confirmed. Candida albicans was detected by microscopic examination of the vegetation. The total of 1500mg of Amphotericine-B were administered intravenously after operation. His postoperative course was uneventful. We discussed about the availability of echocardiogram for diagnosis and the effectiveness of a combination of chemotherapy and valve replacement for treament of fungal endocarditis.
4.Geographical Information Analysis of Difficulty of Access to Hospital to the Elderly Living in Mountainous Areas
Masayoshi IDE ; Tomihiro HAYAKAWA ; Reiko KASHIWADA ; Eriko YONEDA ; Nozomu ANDO ; Toshitaka WATARIGUCHI ; Yoshinori SUZUKI ; Shinya KOBAYASHI ; Mizuo TSUZUKI ; Yoshie ESAKI ; Ken KATO ; Hiroshi AMANO ; Makoto MIYAJI
Journal of the Japanese Association of Rural Medicine 2013;61(4):582-601
We examined how difficult it would be for the elderly living in mountainous areas to go to the nearest hospital using a Voronoi tessellation representing the mathematical concept of neighborhood. We defined the index of the nursing-care capacity for the elderly as the ratio of the number of caregivers to the number of the elderly receiving nursing-care.
The mean age of those who drive to the hospital by themselves worked out at 70±9.8 years. Meanwhile, that of those who go to the hospital by bus or taken to hospital in a car driven by a family member came to 80±7.0years. The latter was significantly older than the former.
The areas of the Voronoi tessellation generated by patients' places of residence were divided into three groups according to the size. The plots of these three groups of the the places of residence on the map had a three-layer and doughnut-like structure, i. e., inner-, middle-, and outer-layer.
The index of the nursing-care capacity in 2008 was less than 1.0 for the patients under 80 years of age. This means that when those who were at the age of 50 in 2008 become old and need nursing-care, access to the hospital will become harder to them than at present. For those who are over 80 years of age and live in the outer layer that is far away from arterial road, it will be almost impossible.
These findings suggest that outpatient care with transportation assistance by a family member at present should be reconsidered because of the future lack of care personnel. It would also be necessary to consider the welfare of older people from the geographical point of view in order to manage the problems concerning the various physical and sociological difficulties of the elderly.
5.Phase I/II prospective clinical trial for the hybrid of intracavitary and interstitial brachytherapy for locally advanced uterine cervical cancer
Naoya MURAKAMI ; Miho WATANABE ; Takashi UNO ; Shuhei SEKII ; Kayoko TSUJINO ; Takahiro KASAMATSU ; Yumiko MACHITORI ; Tomomi AOSHIKA ; Shingo KATO ; Hisako HIROWATARI ; Yuko KANEYASU ; Tomio NAKAGAWA ; Hitoshi IKUSHIMA ; Ken ANDO ; Masumi MURATA ; Ken YOSHIDA ; Hiroto YOSHIOKA ; Kazutoshi MURATA ; Tatsuya OHNO ; Noriyuki OKONOGI ; Anneyuko I. SAITO ; Mayumi ICHIKAWA ; Takahito OKUDA ; Keisuke TSUCHIDA ; Hideyuki SAKURAI ; Ryoichi YOSHIMURA ; Yasuo YOSHIOKA ; Atsunori YOROZU ; Naonobu KUNITAKE ; Hiroyuki OKAMOTO ; Koji INABA ; Tomoyasu KATO ; Hiroshi IGAKI ; Jun ITAMI
Journal of Gynecologic Oncology 2023;34(3):e24-
Objective:
The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial.
Methods:
Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%.
Results:
Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met.
Conclusion
The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.